Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 05502 | Date 21/06/2019 |
| Token No | SM/19-20/5118 22/06/2019 | Serial | 079 Last Visit: 22/06/2019 |
| Patient Name | Mr. ARUP SAHA | Contact No | 9088144336 |
| Address | SHEORAPHULI SHIBAJI BAG | Age | 35 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 73.5 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||